Journal
NATURE
Volume 514, Issue 7523, Pages 503-+Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/nature13633
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Funding
- Wellcome Trust [WT088357/Z/09/Z, WT084210/Z/07/Z]
- National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (Beta Cell Biology Consortium)
- Juvenile Diabetes Research Foundation
- Swiss National Science Foundation [NRP63]
- Medical Research Council [MC_UU_12012/3] Funding Source: researchfish
- MRC [MC_UU_12012/3] Funding Source: UKRI
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Total or near-total loss of insulin-producing beta-cells occurs in type 1 diabetes(1,2). Restoration of insulin production in type 1 diabetes is thus a major medical challenge. We previously observed in mice in which beta-cells are completely ablated that the pancreas reconstitutes new insulin-producing cells in the absence of autoimmunity(3). The process involves the contribution of islet non-beta-cells; specifically, glucagon-producing alpha-cells begin producing insulin by a process of reprogramming (transdifferentiation) without proliferation(3). Here we show the influence of age on beta-cell reconstitution from heterologous islet cells after near-total beta-cell loss in mice. We found that senescence does not alter alpha-cell plasticity: alpha-cells can reprogram to produce insulin from puberty through to adulthood, and also in aged individuals, even a long time after beta-cell loss. In contrast, before puberty there is no detectable alpha-cell conversion, although beta-cell reconstitution after injury is more efficient, always leading to diabetes recovery. This process occurs through a newly discovered mechanism: the spontaneous en masse reprogramming of somatostatin-producing delta-cells. The juveniles display somatostatin-to-insulin delta-cell conversion, involving dedifferentiation, proliferation and re-expression of islet developmental regulators. This juvenile adaptability relies, at least in part, upon the combined action of FoxO1 and downstream effectors. Restoration of insulin producing-cells from non-beta-cell origins is thus enabled throughout life via delta- or alpha-cell spontaneous reprogramming. A landscape with multiple intra-islet cell interconversion events is emerging, offering new perspectives for therapy.
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